New Laser CPT Code for 2024
There will be a new CPT code for low-level laser in 2024. In this article, I will answer the following the questions:
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.
This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.
Check Our Past Webinars!
Leave a Reply
Your email address will not be published. Required fields are marked *This site uses Akismet to reduce spam. Learn how your comment data is processed.
What should the going rate be for this CPT code 97037?
That would be for you to determine.
That’s interesting that it’s an untimed code and and requires constant attendance. I always thought that constant attendance codes were timed and fell in the 9703xx category. I thought those that fell in the 9701xx-9702x range were untimed and did not require constant attendance.
Am I missing anything with the CPT code pattern/rationale?
To you knowledge, will there be ICD-10 diagnosis code requirements since the definition has post-operative pain management? At this time, CMS does not reimburse for it while the jury is out on other payers.
I do ont believe that will occur.
Can low-level laser therapy be combined with Manual Therapy or other CPT codes?
You would want to look at the new version of NCCI edits.
Sorry, I meant to ask if low level laser therapy can be billed under Manual Therapy (as a means of treating soft tissue – similar to suction?).
No!
Is this only approved for PTs, like the dry needling code?
Would Class IV Laser fall under this – it is thermal.
No!
I am finding the billing of Laser complicated and unclear and could really use a hand clarifying the rules.
Here is what I think I understand:
The new code (97037) is billable to Medicare but not reimbursed. It is not timed coded so it will need to be billed regardless of the time spent on it and the bill will be the patient’s responsibility. It only applies for post operative pain though so any patient being treated conservatively will need to be billed another code:
Traditionally Laser has been billed as 97039: Unlisted modality: billable to Medicare but not reimbursed. Timed coded so the bill would be patient responsibility if more than 8 minutes is spent on it.
In 2019 O552T came out which is: Low- Level laser therapy, dynamic photonic and dynamic thermokinetic energies provided by a physician or other qualified health professional. This is a non-timed coded
Lastly there is code: S8948: Application of a Modality (requiring constant provider attendance) to one or more areas; low level laser. Each 15 minutes.
Apparently, this is a Private Payer code only and is not reportable to Medicare
It seems clear that for post-operative pain you would bill 97037. If the patient is not post operative what would be the appropriate code to bill Medicare? Private payers?
What a pain for a treatment that is not paid for by anyone anyway.